The history of intestinal transplantation can be traced back to the turn of the twentieth century. Although advancements have been made, the intestine still presents a greater challenge to transplantation than does that of other solid organs, experiencing higher rates of graft rejection and lower long-term survival. Increasingly, intestinal re-transplantation (re-ITx) is seen as a viable option and is now the fourth most common indication for ITx. Changes to immunosuppression protocols, technical modifications, and infectious disease monitoring have contributed to improved outcomes. The authors review the literature on re-ITx in regard to the history, management considerations, and future directions.
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http://dx.doi.org/10.1016/j.gtc.2024.01.004 | DOI Listing |
Clin Kidney J
October 2024
Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
Introduction: Transplant vasculopathy resembles atherosclerotic plaque formation and is a major contributor to late graft failure in kidney transplant recipients (KTR). Remnant lipoproteins and associated triglycerides are causal risk factors for atherosclerotic plaques and have been implicated in late kidney graft failure. However, whether remnants derived from liver (containing apolipoprotein [apo] B100) or intestine (containing apoB48) are clinically more important is unclear.
View Article and Find Full Text PDFGastroenterol Clin North Am
September 2024
Division of Liver and Pancreas Transplantation, Department of Surgery, The Dumont UCLA Transplant Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address:
The history of intestinal transplantation can be traced back to the turn of the twentieth century. Although advancements have been made, the intestine still presents a greater challenge to transplantation than does that of other solid organs, experiencing higher rates of graft rejection and lower long-term survival. Increasingly, intestinal re-transplantation (re-ITx) is seen as a viable option and is now the fourth most common indication for ITx.
View Article and Find Full Text PDFTranspl Int
October 2023
Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
Primary sclerosing cholangitis (PSC) is the classical hepatobiliary manifestation of inflammatory bowel disease (IBD) and a lead indication for liver transplantation (LT) in the western world. In this article, we present a Consensus Statement on LT practice, developed by a dedicated Guidelines' Taskforce of the European Society of Organ Transplantation (ESOT). The overarching goal is to provide practical guidance on commonly debated topics, including indications and timing of LT, management of bile duct stenosis in patients on the transplant waiting list, technical aspects of transplantation, immunosuppressive strategies post-transplant, timing and extension of intestinal resection and futility criteria for re-transplantation.
View Article and Find Full Text PDFPediatr Transplant
May 2023
Hillman Center for Pediatric Transplantation, UPMC-Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Background: Operational tolerance after retransplantation of the intestine has never been reported.
Purpose: To two recently described intestine transplant recipients with operational tolerance, we now add a third.
Methods: Review of case record and immunological testing to confirm donor-specific hyporesponsiveness in multiple immune cell compartments.
PLoS One
January 2021
Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin, Berlin, Germany.
Background: De-novo malignancies after kidney transplantation represent one major cause for mortality after transplantation. However, most of the studies are limited due to small sample size, short follow-up or lack of information about cancer specific mortality.
Methods: This long-term retrospective analysis included all adult patients with complete follow-up that underwent kidney transplantation between 1995 and 2016 at our centre.
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